Form 1735, CDS Employer and Financial Management Services Agency Service Agreement

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Effective Date

7/2026

Instructions

Updated: 7/2026

Note: These instructions are also used with Form 1735-S (Spanish) and the following addendums:

AddendumFormat
Form 1735-CFC, Service Provision Requirements Addendum, Community First Choice (CFC)
Form 1735-CLASS, Service Provision Requirements Addendum, Community Living Assistance and Support Services (CLASS)
Form 1735-DBMD, Service Provision Requirements Addendum, Deaf Blind with Multiple Disabilities (DBMD)
Form 1735-HCS, Service Provision Requirements Addendum, Home and Community-based Services (HCS)
Form 1735-MDCP, Service Provision Requirements Addendum, Medically Dependent Children Program (MDCP)
Form 1735-PCS, Service Provision Requirements Addendum, Health and Human Services Commission (HHSC) Personal Care Services (PCS)
Form 1735-PHC, Service Provision Requirements Addendum, Primary Home Care (PHC) Services, Community Attendant Services (CAS) and Family Care (FC)
Form 1735-SP, Service Provision Requirements Addendum, STAR PLUS Home and Community Based Services (HCBS) Program
Form 1735-TxHmL, Service Provision Requirements Addendum, Texas Home Living (TxHmL)

Purpose

Documents the separate and mutual responsibilities of the employer and the financial management services agency (FMSA). Use the Consumer Directed Services (CDS) option.

Provides program specific information about the services that can be self-directed, service provider qualifications, service delivery documentation and training requirements.

Procedure

When to Prepare

The employer and FMSA complete Form 1735 or Form 1735-S and the applicable addendum:

  • when the FMSA conducts the employer orientation;
  • any time the employer changes FMSAs;
  • if the employer changes, such as when a person turns 18 and becomes the employer; or
  • if the person changes programs.

Number of Copies

Original and one copy.

Transmittal

The employer keeps the original on file and provides a copy to the FMSA.

Form Retention

The employer and all parties must keep the form and addendum for:

  • six years after signing the form and addendum; or
  • until all outstanding litigation, claims or audits are resolved.

Detailed Instructions for Form 1735 Employer and Financial Management Services Agency Service Agreement

Initial Information

The name of the person receiving services — Enter the person’s name.

The person’s community-based services program is — Enter the name of the program.

The name of the employer is — Enter the name of the employer.

The employer is the — Check the box that applies: person, parent of a minor or court-appointed guardian of the person.

This Agreement is between the employer and — Enter the FMSA name and the city in Texas where the FMSA is located.

The FMSA has a contract to provide financial management services with — Check the box that applies: HHSC or a managed care organization (MCO).

The employer agrees to each of the following requirements — The CDS employer must initial each item listed.

Acknowledgement of Service Agreement — The employer prints his or her name and signs and dates the form. The FMSA representative prints their name, signs and dates the form, and enters the FMSA contract number.

Signing the Addendum forms:  

Employer or Designated Representative Signature and Date — The employer or designated representative signs and dates the last page of the addendum.